Hepatitis B virus transmission and health care workers: Epidemiology, pathogenesis and diagnosis

Hepatitis B infection is a preventable disease, infecting approximately two billion people worldwide and causing a million deaths annually. Around 2 million healthcare workers are exposed to Hepatitis B and have ten times higher risk of contracting the disease due to occupational exposure. In Asia, the seroprevalence is estimated between 15%-21%. The diagnosis of Hepatitis B is done mainly by detection of viral markers with the help of serologic tests. Nowadays molecular tests are increasingly being used both for diagnosis and management of patients. Vaccination of the healthcare worker is of utmost importance in the prevention of hepatitis B virus infection as it decreases the transmission effectively. According to CDC guidelines, an infected healthcare worker should not perform exposure prone procedures at HBV DNA levels more than 1000 IU/ml and an expert panel monitors the treatment. Seven drugs have been approved by US-FDA for treatment of HBV infection. The incidence of HBV has decreased since the advent of universal precautions and safe disposal of infected waste and sharps. Inclusion of Hepatitis B vaccination in the universal immunisation programme is also a major step in reducing the incidence of HBV infections.